The Golden Age of Parenting

Advanced reproductive technologies have allowed record numbers of women to postpone childbirth into or even past menopause. But experts caution that graying first-time parents might face discrimination, high-risk pregnancies, and delayed retirement--not to mention exhaustion.

Earlier this year, a Romanian professor who writes children's books might have become the oldest woman ever to give birth when she delivered her first child at age 66, say news reports. Although Adriana Iliescu is an extreme example, more women than ever are defying their biological clocks and starting families later in life. The U.S. birthrate for women aged 40 to 44 has more than doubled in the past 20 years, and in 2003 the number of babies born to women older than 40 in a single year topped 100,000 for the first time.

Many women put off having children to pursue careers or to find the right partner. Some are delayed by difficulties becoming pregnant. Other couples choose to add to their existing brood later in life. Yet experts warn that people who have been reassured by the frequent and favorable news reports of successful births to much older women might be caught off-guard by the physical, emotional and financial consequences of postponed parenting.

Biologically, there seems to be no upper limit for motherhood. Women can carry babies long after their own eggs are viable. "It's not the age of the uterus, it's the age of the egg," says Richard Paulson, director of the fertility program at the University of Southern California in Los Angeles and co-author of Rewinding Your Biological Clock: Motherhood Late in Life. Because of aging eggs, women experience a marked drop in fertility, beginning at age 35 and bottoming out by 45 (see "Reproductive Retirement"). But thanks to assisted reproductive technologies, women who are healthy and wealthy enough to afford it can give birth using eggs from younger donors, as Iliescu did. The borrowed eggs are incubated with sperm, and the resulting embryos are implanted by the same techniques used in standard in vitro fertilization (IVF) procedures.

And when women over 50 are carefully screened for health problems that might complicate pregnancy--such as heart disease, hypertension, and glucose intolerance--the live birthrate for donor eggs is similar to that of younger women who get pregnant by IVF using their own eggs, Paulson reports. But he discourages those over 55 from getting pregnant. Even the healthiest women over 55 experience much higher rates of gestational diabetes and life-threatening pregnancy-associated hypertension than younger mothers, he and his colleagues find. And older women are also more likely to give birth to low-birth weight or premature babies and deliver by caesarian section.

Unfortunately, many women don't hear the full story until it is too late to make other plans. Jane Miller, medical director of the North Hudson IVF Center in Englewood, New Jersey, received a flood of inquiries from hopeful older women seeking help becoming moms after Miller's patient, Aleta St. James of Manhattan, delivered twins at age 56 in November 2004. But "when women learn what is entailed and what the risks are, most say, ‘No thank you,’ " says Miller, who was rejected repeatedly by infertility clinics 10 years ago at age 42. Miller now has a son, 9, only because she treated herself with hormone injections to boost her egg production--and her chances of success.

Despite the evidence that older women can and do give birth to healthy babies, those opting to delay childbearing can face unexpected age-related barriers to reproductive assistance. The American Society for Reproductive Medicine frowns on postmenopausal pregnancy, noting that "infertility should remain the natural characteristic of menopause." The group has begun a concerted effort to make the public more aware of the risks of delaying childbearing.

And society on the whole might not be ready to fully embrace older parents, whether they build their families in the clinic or by adoption. "I can't tell you how many times I am asked if our two sons [now 11 and 13] are our grandkids," says Rich Szlosek of Northampton, Massachusetts, who adopted his first child when he was 52, the same age as the boy's birth grandmother. "I just laugh. The kids get a big kick out of it."

Some adoption agencies refuse to work with older parents, says Joan Clark, executive director of the ODS Adoption Community of New England, a nonprofit educational and support organization. For people seeking to adopt white American infants, age 40 can be a cutoff. International adoptions tend to top out a little later, but strict limits are set by the country of origin.

Such age limits might seem discriminatory, but some experts express concerns about the long-term welfare of the children being raised by older parents, who might be healthy at 50 but chronically ill at 65. "Most people think about pregnancy and infancy," says Joann Paley Galst, an independent psychologist in New York City who counsels older people contemplating parenthood. "I ask them to think through their plans for the future." Although all parents need to think about potential guardians in case of their own deaths, the children of older parents are more likely to have to depend on those plans.

Even if older parents remain healthy, their energies can fade. Szlosek says he had lost the stamina to throw and run by the time one of his sons showed a talent for baseball. Now, at 65, he refers wistfully to friends and colleagues who have retired. He expects to work at his family law practice at least seven more years to meet the financial crunch of college and retirement expenses. Child-care costs can be another surprise for working parents, especially when their own elderly parents have passed the baby-sitting stage.

But delayed childbearing also has its advantages. Couples who hold off building families might be more stable financially and emotionally. And maybe that's when they're ready. Cara Birrittieri, a former television reporter and author of What Every Woman Should Know About Fertility and Her Biological Clock, had her first child at 40 and then used donor eggs to produce a second at 44. "It was everything I had dreamed of for a long time," she says. And although Birrittieri lost her own 76-year-old father when she was 16, she looks forward to spending many years with her children. "When I'm 60, Victoria will be 16, and I'll still be able to ski with her," Birrittieri says. Odds are she'll navigate the parenthood slalom as well as any 20-something snow bunny.

Carol Cruzan Morton lives in the Boston area and also hopes to be able to schuss down the slopes with teenagers at age 60.